Individual provider Active NPI

Christopher Scott Beaver, D.C.

  • Chiropractor
  • Canton, GA
National Provider Identifier
1316021256
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
GA5033 Issued in GA
Practice address
1353 Riverstone Pkwy
Suite 140
Canton, GA 30114-5634
Phone
(770) 479-5511
Fax
(770) 479-1787
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X GA5033 GA Primary

Addresses

Primary practice location

1353 Riverstone Pkwy
Suite 140
Canton, GA 30114-5634

Mailing address

1353 Riverstone Pkwy
Suite 140
Canton, GA 30114-5634
Phone (770) 479-5511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805000068 GA Practitioner - Chiropractic 1759352446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

214 Riverstone Dr
Canton, GA 30114-5256
Phone (770) 479-5511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
GA5033GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Riverstone Chiropractic LLC Chiropractor CurrentSince Jul 14, 2003 Accepting new patients

Locations

1353 Riverstone Pkwy
Ste 140
Canton, GA 30114
Phone (770) 479-5511

214 Riverstone Dr
Canton, GA 30114
Phone (770) 479-5511

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1316021256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1353 RIVERSTONE PKWY",
            "address_2": "SUITE 140",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145634",
            "telephone_number": "770-479-5511",
            "fax_number": "770-479-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 RIVERSTONE PKWY",
            "address_2": "SUITE 140",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145634",
            "telephone_number": "770-479-5511",
            "fax_number": "770-479-1787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEAVER",
        "first_name": "CHRISTOPHER",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "GA5033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.